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General NPI Number Information
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NPI Number | 1619641453
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Entity Type | Organization
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Legal Business Name | ORTHOCAROLINA
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 6237 CAROLINA COMMONS DR STE 110
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City | INDIAN LAND
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State | SC
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Zip | 29707-4513
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Country | US
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Telephone | 803-266-7547
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Fax | 803-849-8391
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Provider Business Mailing Address
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Address Line | 4601 PARK RD STE 300
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City | CHARLOTTE
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State | NC
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Zip | 28209-2290
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Country | US
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Telephone | 704-696-2256
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Fax | 704-945-7681
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Authorized Official
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Title or Position | CFO
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Name | BRENT SHEAR
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Credential |
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Telephone | 704-323-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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